保留冠状动脉的猪心螺旋形心室肌带的解剖

Dissection of helical ventricular myocardial band in the heart of swine with sparing of the coronary artery system

目的探索保留完整冠状动脉的猪心螺旋形心室肌带（helical ventricular myocardial band，HVMB）的解剖方法。方法取33只新鲜猪心，随机分成11组，每组3只，冠状动脉内分别选择性地注入160％硫酸钡（Ⅰ型）混悬液，猪心于水中煮沸、冷却后移除心房组织，但完整保留心脏表面的冠状动脉及房室沟和室间沟周围的脂肪组织，适当离断冠状动脉的主干及其分支，参考Torrent-Guasp等的HVMB解剖方法用手指行钝性解剖。结果在冠状动脉保留完整的基础上，将猪心心室肌解剖出一条起点为肺动脉根部，终点到主动脉根部连续的肌肉带。结论成功保留完整冠状动脉的猪心HVMB解剖有益于完善和加深HVMB理论的理解和认识，可为探求基于HVMB理论的冠状动脉疾病及其相关疾病的研究提供解剖上的技术支持。

Objective Based on the Helical Ventricular Myocardial Band （HVMB） theory proposed by Torrent-Guasp, the ventricular myocardial band extends from the root of the pulmonary artery to the root of the aorta with two helical coils. This new theory is considered as a revolutionary concept for further understanding the global, three-dimensional and functional architecture of the ventricular myocardium. No report had described techniques for dissecting HVMB while keeping the integrity of the coronary artery system. We explored techniques for dissecting HVMB in swine.Methods 33 fresh swine hearts were randomly divided into 11 groups, 3 hearts in each. 160% barium sulfate （type Ⅰ ） suspension was injected into the coronary artery system. The coronary arteries were ligated. The atrial tissue was removed following putting the hearts in boiling water then cooling for several hours. The superficial coronary vessels and fat tissue around the atrio-ventricular and inter-ventricular sulcus were preserved. Some branches of the left anterior descending artery, distal segment of posterior descending branch, and middle and distal segment of obtuse marginal branches were mutilated appropriately. HVMB dissection was completed with fingers in accordance with Torrent Guasp＇s technique. Results A continued bundle of muscle, originated at the root of pulmonary artery and ended at the root of aorta, was tmwrapped along the major direction of the cardiac muscle fiber in all of the 33 hearts with sparing of the coronary artery. The swine hearts＇ ventricular myecacdium was composed of two loops, with basal loop from the root of the pulmonary artery to the anterior papillary muscle and apical loop from the beginning of the anterior papillary muscle to the mot of the aorta. Each loop consisted of two segments： the right segnsent-coinciding with the right ventrieular flee wall and the left segment-coinciding with the basal of the left ventrieular free wall. Posterior papillary muscle, which belongs to the descendant segment, demarcated the border between the descendent and the ascendant segments of the HVMB＇s apical loop. Conclusion Although controversies about the theory of the HVMB remain, we have dissected the HVMB in the swine hearts＇ ventrictdar myocardium successfully with sparing of the coronary artery systems. This dissection procedure provides technical information for the studies of associated diseases based on the theory of HVMB.